In the dim lighting of British Columbia Children’s Hospital emergency waiting room, 14-year-old Maya sits hunched between her parents, hair obscuring her face, a hospital bracelet already loose around her thin wrist. It’s been seven hours since they arrived after Maya experienced suicidal thoughts at school. The triage nurse assessed her quickly, but now they wait – joining dozens of families across Canada facing what pediatric emergency physician Dr. Natasha Thompson calls “our invisible crisis.”
“We’re seeing children waiting 12, sometimes 18 hours for a psychiatric assessment,” Dr. Thompson tells me during a rare quiet moment in her shift. “These kids aren’t waiting because we don’t care. They’re waiting because the entire system is overwhelmed.”
New research published in the Canadian Medical Association Journal confirms what frontline workers already know: children and teens experiencing mental health emergencies wait significantly longer than those with physical complaints. The study found median wait times averaging 13 hours for psychiatric assessments, with some patients waiting more than 24 hours in emergency departments never designed for extended mental health care.
Maya’s mother Jessica, who asked I change their names to protect her daughter’s privacy, describes the experience as “healthcare purgatory.”
“She’s not stable enough to go home, but not actively harming herself right now. So we sit and wait while she gets more anxious, more agitated. How is this helping?” Jessica whispers, eyes darting toward Maya who’s finally fallen asleep against her father’s shoulder.
The waitroom scene I witness in Vancouver mirrors findings from a recent study out of Toronto’s Hospital for Sick Children, where researchers tracked over 1,800 pediatric mental health visits. Not only did these patients wait substantially longer than others, but the delays created cascading problems throughout emergency departments already strained by staffing shortages and post-pandemic surges.
“When mental health patients occupy emergency beds for extended periods, it backs up the entire system,” explains Dr. Elizabeth Martin, pediatric emergency medicine specialist at SickKids and lead author of the study. “We’re seeing increased wait times for all patients, staff burnout, and concerning outcomes for the very kids we’re trying to help.”
Data from the Canadian Institute for Health Information shows emergency department visits for children’s mental health concerns have increased by 61% over the past decade, with dramatic spikes following pandemic lockdowns. Despite this rising tide, specialized resources haven’t kept pace.
Walking through the emergency department during my reporting, I count four young patients with mental health concerns, each occupying beds that would typically see multiple physical emergency patients in the same timeframe. Overworked nurses check on them between managing other emergencies, but the environment itself—bright lights, constant noise, minimal privacy—undermines recovery.
“This is nobody’s first choice,” explains Kamal Joshi, a psychiatric nurse who divides his time between the emergency department and community mental health. “We’d much rather see these kids in appropriate settings with specialized staff, but when families can’t access those services or can’t wait weeks for appointments, the emergency room becomes the only option.”
The strain extends beyond urban centers. In northern British Columbia communities, the situation grows even more dire. Some children are transported hundreds of kilometers for assessment because local facilities lack psychiatric specialists. Indigenous communities face additional barriers, with historical trauma and cultural disconnection compounding mental health challenges while access to culturally appropriate care remains limited.
“Our young people deserve better than emergency rooms,” says Marilyn Joseph, a mental health coordinator with the Wet’suwet’en Health Centre. “They need preventative programs, land-based healing, and services that understand their cultural context. Instead, they’re waiting in emergency rooms surrounded by strangers until they’re either admitted or sent home with a referral that might take months to fulfill.”
Solutions exist but require systemic change. Alberta’s recent pilot program embedding mental health professionals directly in pediatric emergency departments has shown promising results, reducing wait times by 40% while improving patient outcomes. British Columbia’s Foundry centers provide integrated youth services in community settings, though demand far exceeds capacity.
Back at BC Children’s Hospital, Maya’s family continues waiting as afternoon stretches into evening. A social worker brings them sandwiches and updates: they’re trying to find a psychiatric resident to complete her assessment. The emergency department has received three more mental health cases since they arrived.
Dr. Thompson sighs when I ask about solutions. “We need a complete rethinking of how we deliver mental health care to young people. The emergency department will always be necessary for crisis situations, but we’re currently using it as a bandaid for a broken system.”
For now, families like Maya’s have little choice but to wait in emergency departments across the country – caught between crisis and care in a system struggling to meet their needs.
As I leave the hospital, I pass Jessica stepping outside for fresh air. “Thirteen hours now,” she says quietly. “They’re saying maybe another three before someone can see her. I just keep thinking – if this were a broken arm or appendicitis, would we still be waiting?”
Her question hangs in the air, unanswered but urgent – much like the crisis itself.
